HEALTHCARE: Will it be ACA or AHCA… How About HCSM?

HEALTHCARE: Will it be ACA or AHCA… How About HCSM?

By Mike Brooks with the Care Assistance Center, LLC

The latest news in healthcare speaks about the House passing the American Health Care Act to repeal and replace the Affordable Care Act , also known as Obamacare. What kind of changes can we expect to our healthcare system if this new law is passed by the Senate?

Buying insurance through the marketplace will no longer be a requirement if you want to use tax credits or subsidies to pay for coverage. The new bill will also eliminate the tax penalty for not having insurance by removing the mandate all together. The bill encourages people to maintain coverage by allowing insurance companies to charge 30% more for premiums for those with preexisting medical conditions that have a lapse or break in coverage for more than 63 days in a row.

Protection for those that have preexisting conditions is included in the bill to allow people with high medical expenses to pay the same for a policy of someone the same age in good health. There are some important exceptions to consider, though. States will have the ability to opt out of this by applying for what are called “state waivers” that allow insurance companies to charge up to five times more for older individuals than younger, remove some required essential coverage such as maternity care and prescription drugs, and charge more or deny coverage for those with preexisting conditions like cancer and diabetes. (Basically insurance companies go back to doing things the way they did before Obamacare.)

Tax credits and subsidies based on income will be eliminated and replaced by age-based tax credits ranging from $2,000 a year for younger individuals and $4,000 for those over 60. Tax cuts will be implemented for those with higher incomes that were helping to pay for the tax credits and subsidies for the lower income households.

To summarize the above, costs will increase for many and coverage will decrease for many in states that apply for waivers. All in all, it seems healthcare will continue to follow a similar path as it has.

This leads to a discussion about HCSM health plans.

HCSM stands for Health Care Sharing Ministries. They are nonprofit groups that pool members together to pay for health care and are currently exempt from penalties with Obamacare. These plans often offer more comprehensive care for much less cost than plans in the marketplace. They manage care through coordination with local physicians and hospital networks, just like insurance companies. HCSM plans do have some limitations and usually require one or one’s family to acknowledge their faith in a higher power, often referred to as God, and to live healthy, active lifestyles that include no smoking and abstinence from drug and alcohol abuse. Also, many plans restrict preexisting conditions for a limited time period to help keep costs low for members.

At the Care Assistance Center we know many of our clients may be faced with high premiums, high deductibles, and high out of pocket costs for their health care. We work with several companies to help reduce health care premiums and improve coverage so you can be prepared for the evolving changes in America’s health care system.

If you are interested in learning more about health insurance, including HCSM plans, please contact The Care Assistance Center, LLC for more information. We have kind and helpful staff here to help: (919) 518-8237.